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The Only Thing We Have To Fear

by @ 4:34 pm on October 16, 2005. Filed under Bird Flu

In today’s Washington Post, Wendy Orent interjects some much needed sanity into the Avian flu story.

For two years, a deadly strain of chicken flu known as H5N1 has been killing birds in Asia. While slightly more than 100 people are known to have contracted the disease, and 60 of them have died, there is still no sign that the flu has begun to spread from person to person.

That hasn’t prevented a recent outbreak of apocalyptic warnings from health officials and experts about the specter of a worldwide pandemic. In Hurricane Katrina’s wake, health officials in the United States are talking more and more about pandemic preparation. Some of these ideas — such as stockpiling vaccines — are sensible, whether or not bird flu turns into a human disease and begins to spread rapidly.

To read some reports in the blogosphere and the media, we are on the verge of a pandemic that would rival the 1918 flu, which killed millions of people. The reality is significantly different, of course, but that hasn’t stopped politicians and others from making some truly disturbing proposals.

Another dangerous idea for pandemic preparation has come from President Bush. Earlier this month, he suggested using the military to enforce a quarantine. “Who [is] best to be able to effect a quarantine?” he asked rhetorically at a press conference. “One option is the use of a military that’s able to plan and move.”

The idea of using the military to respond to a flu pandemic or any other natural disaster does make some sense in light of the debacle that followed Hurricane Katrina. However, as I argued in September, and as Orent argues now, this is a very dangerous proposal.

This is an example of a cure that is as frightening as the disease. It is hard to imagine how the military would oversee a quarantined area. If a health worker, drug addict or teenager attempted to break the quarantine, what would soldiers do? Shoot on sight? Teenagers and health workers were the people who most often violated quarantine rules in Toronto during the severe acute respiratory syndrome (SARS) scare in 2003. Moreover, the use of a quarantine to control a flu pandemic isn’t only a potential threat to life and civil liberties; it’s also a waste of money, resources and time. The reason: There isn’t any kind of quarantine that will do any good — at least not for a pandemic influenza.

Shooting people that don’t respond to orders is certainly an option in the military arsenal, but would we really want to see American soldiers even threatening to shoot at American citizens in order to force them to stay in a certain area ? I don’t

Furthermore, as Orent points out, quarantine in the context of the flu may actually make things worse:

Indeed, a strictly enforced quarantine could do more harm than good. Herding large numbers of possibly infected people together makes it likely that any influenza strain passed among them would actually increase in virulence. Usually, in order to spread, human flu germs need hosts mobile enough to walk around and sneeze on other people. Those flu strains so deadly that they kill or disable their hosts won’t get the chance to spread and will die off. This keeps human flu virulence within bounds.

Imagine a bunch of sick people herded into something like the Superdome, or a high school gymnasium. It would be a breeding ground for the worst versions of the virus.

Of course, quarantine isn’t the only dangerous proposal being made in the face of a still nonexistent epidemic. Andrew Sullivan, who once called himself a libertarian conservative, has called for the abrogation of Roche’s property rights in the anti-viral medicine Tamiflu, as are others. As Tyler Cowen explains that would be a very bad idea. But then bad ideas are often born out of supposed emergencies.

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